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Indeed, vitamin D produced in the skin through sunlight may last at least twice as long in the body compared to ingesting the vitamin, according to a review in the April-June 2012 issue of the Journal of Pharmacology & Pharmacotherapeutics. Experts also believe that a general state of hyperarousal may cause insomnia. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify. Your body may feel like it cant settle down, and everything makes you twitch. Momentary vertigo associated with rapid head movements typifies benign paroxysmal positional vertigo. From awareness of the eating disorder to recovery maintenance, the role of the primary care nurse evolves, but what doesn't change is the positive influence nurses can have on those with an eating disorder. relaxation techniques to help patients. Accessed Aug. 18, 2021. believe that information is only as helpful as its accuracy. This article explains some of the symptoms and causes of vitamin D deficiency, as well, Not getting enough B12 in your diet can cause debilitating mental and physical health issues. You want something that can cure your anxiety forever right now. That's the hallmark of PTSD. Merck Manual Professional Version. Calm Clinic Editorial Team and Summary People who eat few fresh fruits and vegetables may develop vitamin C deficiency. Everything makes her jumpy. Updated on October 10, 2020. us on servers located in countries outside of the EU. Three ounces of salmon, tuna or trout will provide more than enough, and a cup of milk or low-fat yogurt will get you halfway there. Inflammation. updated: April 8, 2021 Accessed Aug. 18, 2021. By continuing 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). "For example, when you're sauting spinach, throw in red peppers or tomatoes.". Elsevier; 2020. https://www.clinicalkey.com. For instance, excess selenium and vitamin A, two nutrients often added to hair growth supplements, have both been linked to hair loss (34). In children, it can cause rickets. Symptoms of vitamin deficiency include brittle hair and nails, mouth ulcers, hair loss, scaly skin patches, and more. People experiencing vitamin A deficiency could have problems with their skin, such as dryness, itching, and scaling. The same may be the case for vitamin K deficiencies, though more research is needed. Make a donation. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with . See if Ritual products are right, It's no secret that vitamins can improve your health, but not all vitamins and minerals are created equal. However, there may be other causes of bruising. The Possible Culprit: Maybe you bump into your desk and find a gnarly black-and-blue on your thigh the next morning. "Get as many fatty acids as you can through food alone," says Melissa Halas-Liang, RD, spokesperson for the California Dietetic Association. ", Journal of Indian Pediatrics: "Beneficial effect of iron pot cooking on iron status. Thats because vitamin A is necessary to produce rhodopsin, a pigment found in the retinas of the eyes that helps you see at night. Those who suspect their vitamin A intake is insufficient can try eating more vitamin-A-rich foods, such as organ meats, dairy, eggs, fish, dark leafy greens, and yellow-orange colored vegetables (27). A diet rich in the following nutrients may help prevent or slow hair loss (34). Researchers around the world have learned much about the effects of the COVID-19 pandemic on mental health. The two parts of a person's autonomic nervous system work together to manage the fight-or-flight stress response. I (30f) have hEDS which appears to be the underlying root cause of my MCAS and dysautonomia. Angular cheilitis, a condition that causes the corners of the mouth to crack, split, or bleed, can be caused by excess salivation or dehydration. Touch something cold like ice or cool water. Find a doctor or location close to you so you can get the health care you need, when you need it. About half of people with a B12 deficiency lose papillaetiny, taste bud-containing bumps. Vitamin deficiency may be caused by an unhealthy diet, starvation or certain medical conditions that make absorbing nutrients difficult. These symptoms are your bodys way of communicating potential vitamin and mineral deficiencies. Vitamin A deficiency is when your body lacks the amount of vitamin A it needs to function properly. Drinking your daily coffee or energy drink can help you feel ready for the day. However, folate deficiency is less common now in countries that routinely add folate to food products such as breads, cereals and pasta. Vitamin B deficiency symptoms include: B1 (thiamine): fatigue and irritability. A variety of factors may cause brittle hair and nails. Nevertheless, its worth noting that unnecessary supplementation can do more harm than good and may reduce the absorption of other nutrients (56). If the multitude of . Often, increasing your intake of foods rich in the appropriate vitamins and minerals can help resolve or greatly reduce your symptoms. Do an aerobic workout, weight training, or other physical activity like heavy chores or yard work. You need help with anxiety. . Vitamin K deficiency is rare in healthy adults because the body stores it in the liver and fat. After all, he is a gray haired old man. information is beneficial, we may combine your email and website usage information with The most common cause of pellagra is insufficient amounts of niacin or tryptophan in the diet. For pescatarians: Try shrimp, scallops, clams and sardines. Seafood, meat, legumes, dairy, nuts, and whole grains are all good sources of zinc (32). One small study notes that patients with mouth ulcers appear to be twice as likely to have low iron levels (10). Your gut may not. https://www.nhlbi.nih.gov/health-topics/pernicious-anemia. Or, choose cow's milk, soy milk, orange juice, oatmeal and cereals that are fortified with vitamin D. Mayo Clinic does not endorse companies or products. The intensity of the response may be affected by the frequency of being startled, fatigue and/or stress. Kaushansky K, et al., eds. It is a fat-soluble nutrient that aids in blood clotting and helps strengthen capillary walls, making them less prone to breaking. And often it's a little underslept. Vitamin A Deficiency. In some cases, digestive issues might prevent the proper absorption of these vitamins. Aches and pains might be a sign of a deficiency. For instance, mouth ulcers, also commonly referred to as canker sores, are often the result of deficiencies in iron or B vitamins. Interviewer: So it doesn't sound like it has anything to do with the organs, or if you might have a heart disease, or it might lead to something in your brain. According to the National Institute of Neurological Disorders and Stroke, RLS affects up to 10% of Americans, with women twice as likely to experience the condition. Perhaps you get a nosebleed for no apparent reason. Finally, some evidence suggests that magnesium insufficiency may play a role in restless leg syndrome (58). B3 (niacin): mental confusion and dementia, along with scaly skin, muscle weakness, and . Vitamin A deficiency can cause vision loss and blindness. Another early symptom of xerophthalmia is Bitots spots, which are slightly elevated, foamy, white growths that occur on the conjunctiva or white part of the eyes. ADS symptoms develop right after the event, and symptoms last no longer than a month. The most common clinical sign of vitamin A deficiency is xerophthalmia, which develops after plasma retinol has been low and the eye's vitamin A reserves have become depleted. The stress response includes physical sensations that prepare you to either fight or flee. B2 (riboflavin): cracks in the corners of the mouth, scaly patches on the head. Your bodys reaction to caffeine becomes another layer of stimulation on an already highly active nervous system. Your body isn't properly absorbing or using vitamin D. There are several specific causes of vitamin D deficiency, including: Certain medical conditions. Nutrient deficiencies may occur with almost every nutrient, but some are more likely than others. This produces red or white elevated bumps on the skin (45). Being hyperarousable or hyperirritable is very difficult to live with. Here well explore some of the more common reasons you may be feeling jumpy. Summary Low vitamin A intake may cause poor night vision or growths on the white part of the eyes. Means RT, et al. Keratosis pilaris is a condition that causes goosebump-like bumps to appear on the cheeks, arms, thighs, or buttocks. It's worthwhile getting it evaluated and talking to your clinician. Interviewer: It's normal to jump at a really loud, unfamiliar sound. Acute stress disorder (ASD) and post-traumatic stress disorder PTSD have overlapping symptoms, with hyperarousal being one of them. Dandruff and seborrheic dermatitis may be caused by many factors, with a nutrient-poor diet being one of them. Summary People with mouth ulcers or cracks at the corners of the mouth may want to try consuming more foods rich in thiamine, riboflavin, pyridoxine, and iron to alleviate symptoms. provide the information. In: Conn's Current Therapy 2021. The startle easily symptom can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur 'out of the blue' and for no apparent reason. By the end of the day, you may feel like your nervous system is frazzled, and you want to crash. 3. Irritability. Common signs and symptoms associated with pellagra include delusions, diarrhea, inflamed mucus membranes, mental confusion and scaly sores on a person's skin. Whether the startle came first or the heartbeat came first is not entirely well known. Here are 9 teas that help treat stomach problems. Pernicious anemia. In: Conn's Current Therapy 2021. information submitted for this request. The body easily absorbs it. If you are a Mayo Clinic patient, this could How Do U Treat Erectile Dysfunction? Since higher iron intakes appear to reduce symptoms, increasing the intake of iron-rich foods, such as meat, poultry, fish, legumes, dark leafy greens, nuts, seeds, and whole grains, may also be beneficial (14). Beriberi results from severe deficiency and can affect the nerves, muscles, heart, and brain. The sympathetic nervous system stimulates the body and gets it ready for action, and the parasympathetic system calms the body down for rest. But if both your toenails and fingernails are prone to breakage, you might be low on iron. by Calm Clinic does not provide medical advice, diagnosis, or treatment. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. Usually, noticeable effects don't begin to develop until you've had low levels for several months. Omega-3s play a key role in moisture retention, according to an August 2018 review in the journal Marine Drugs.. Kellerman RD, et al. All rights reserved. Mayo Clinic; 2021. Vitamin B6: Lack of vitamin B6 causes deficiency diseases such as anaemia and certain skin disorders such as cracks around the mouth. Or perhaps your vehicle broke down on a busy street. a. Babinski b. thrashing c. rooting d. Moro d. Moro The first two weeks of development after conception is a. fetal period. They jump at smaller things, they're hyperirritable, their brain is irritable, meaning, the same loud noises that don't bother other people seem to bother them. While vitamin A deficiency is rare in developed countries, certain people may be at a higher risk. They may also make slow, cautious movements and become nervous in new places. The Possible Culprit: The technical term is myopenia, and there are a variety of causes, from fatigue and stress to consuming too much caffeine and alcohol, according to the Mayo Clinic. Poor night vision and white growths on the eyes, 8 Signs and Symptoms of Vitamin A Deficiency, 7 Nutrient Deficiencies That Are Incredibly Common, Vitamin D Deficiency: Symptoms, Causes, and Treatments. Consuming B12 in your diet can help to prevent vitamin deficiencies that can affect your sense of smell. of signs you need emergency medical attention or call 911. All rights reserved. Your doctor may also suggest a supplement. Written by Micah Abraham, BSc Tryptophan is one of 20 standard amino acids. (Scan the label, and if you see any ingredients that begin with the prefix "dl," it's a factory-made. Biotin, also known as vitamin B7, helps the body convert food into energy. It can also come in waves, where it's strong one moment and eases off the next. This content does not have an Arabic version. ", The Fix: So, how to get more of this nutrient? This can happen if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. Your privacy is important to us. On the other hand, a diet lacking in nutrients may cause various unpleasant symptoms. Bite into a piece of avocado toast or crack open a can of sardines with lunch. Maria Fernandez Gonzalez/Unsplash. Elsevier; 2021. https://www.clinicalkey.com. The growths can be removed to a certain extent but only fully disappear once the vitamin A deficiency is treated (26). "You can eat foods rich in D, like salmon and egg yolks," Jones says, "but it's difficult to get adequate amounts through diet alone.". privacy practices. 5 Science-Based Benefits of 5-HTP (Plus Dosage and Side Effects), The 15 Best Vitamin Brands of 2023: A Dietitians Picks. A lot of things can make you jump: loud noises, people coming up behind you, thunder, the list goes on. Nutrition is a process that serves two purposes: to provide energy and to maintain body structure and function. Outside, the sword cultivators back problems cause erectile dysfunction of the Lotus Mountain lineage were laughing arrogantly. Iron B. Pantothenic acid C. Riboflavin D. Thiamin, Which statement concerning vitamins is INCORRECT? These individuals are exhausted but can't settle their body or mind, causing the state of being tired but wired.. Anxiety attacks (or panic attacks), if you're going by the more technical name - are intense feelings of anxiety that Sign up for our newsletter and get science-backed tips to better manage anxiety and Updated on August 24, 2022. Good Morning, Vertigo is an illusion of movement and is specific for a lesion in the inner ear, vestibular nuclei, or vestibular pathways. With PTSD, symptoms may develop more slowly and can last for months or years, even with treatment. We'll discover what's normal and what's not with being jumpy. Pernicious anemia. Certain medications. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. And being anxious can trigger a very rapid heartbeat. Chronic anxiety disorders can also cause a person to startle easily or overreact to stimuli. In the intestines, mucus-secreting goblet cells are affected, and loss of an effective barrier against pathogens can cause diarrhea or impairment of epithelial . This video is about :Hints to remember Vitamin deficiency manifestations Written by Micah Abraham, BSc c. embryonic period. Without these nutrients, the body produces red blood cells that are too large and don't work properly. Review/update the Well this can happen outside the battlefield as well. These problems are related to consequent low levels of calcium. Its tough to get through the day and night like this, and at some point, you want answers. This may explain why studies performing routine screenings of healthy populations estimate low vitamin C levels in 1330% of the population, with 517% of people being deficient (21). expertise. Mouth ulcers or cracks in the corners of the mouth, 4. Here are the 15 best vitamin brands to help. Most adults need these daily dietary amounts of the following vitamins: Pregnant and breastfeeding women may require more of each vitamin. Of course, getting enough B12 in your diet is always a good idea, too. Over time, a lack of vitamin A means that you may develop problems with vision and be less able to fight infections. Vitamin C plays an important role in wound healing and immunity, and it even acts as an antioxidant, helping prevent cell damage. If you do not agree to such placement, do not Alcohol inhibits the natural breakdown of nutrients in several ways: Decreasing secretion of digestive enzymes from the pancreas. Iron deficiency is more common than . When there is not enough vitamin A in mild levels, the body can be fatigued, susceptible to infection, and sterile. In the case of Beriberi, this condition is caused by a lack of thiamine, or vitamin B1, according to the U.S. National Library of Medicine. As for which nutrient deficiency can contribute to a decreased sense of smell, findings often point to B12. To provide you with the most relevant and helpful information, and understand which Vitamin A. Vitamin A is particularly important for healthy skin and eyes. Vitamin D deficiency symptoms in babies. Five online databases-Embase, PubMed, Scopus, Web of Science, ScienceDirect and pre-print Medrevix were searched. As for brain fog and the blues, a 2016 study published in the journal Current Medicinal Chemistry demonstrated that B vitamins are integral in neuronal function and that deficiencies can lead to depression. Rickets is a disease that causes soft, weak bones in children, per the U.S. National Library of Health. She talks about what makes people hyper-aware of noises and other things happening around them. That is why all of the content that we Updated on October 10, 2020. And this is backed up by research. Had gastric bypass surgery. Little things make them jump. It is treated with folic acid supplementation. Hair loss is a very common symptom. originally published: August 6, 2015. Vitamin D deficiency is incredibly common in Western countries. People who live in cold climates are also at greater risk, since they may not get adequate sun exposure. Deficiencies of water-soluble vitamins, such as most B vitamins and vitamin C, may develop after weeks to months of under-nutrition. First of all, the most predictable is caffeine. Researchers have discovered significantly lower levels of Vitamin D in individuals with anxiety (60, 62). So that can make the brain hyperirritable. A February 2021 review in Nutrition Reviews found that low vitamin C levels in the bloodstream were associated with an increased risk for gum bleeding with gentle probing. Adding these nutrients to the diet may help reduce symptoms. The body goes with the path of least resistance. Why do these things startle you but not others? Anxiety may be a difficult disorder to live with, but it's also a fascinating one. Why does . Eating raw egg whites may cause biotin deficiency as well. Vitamin deficiency anemia can occur if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. 2 . Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures (broken bones). As a result, individuals with severe vitamin B12 might lose or diminish their sense of smell, as an October 2016 study in the International Forum of Allergy & Rhinology found, adding that more research is needed to support these initial findings. It plays animportant role in strengthening hair and nails. Your body sends surges of hormones through your bloodstream and oxygenated blood to large muscles. That said, many people fail to eat enough fruits and vegetables each day. The affected person must be startled by an unexpected event in order to elicit the reaction. here. While any of the above symptoms could indicate a vitamin or mineral deficiency, they could also be caused by something more serious. "If your levels are low, it can lead to excessive bleeding and bruising.". Answer (1 of 9): There are many things that might make a person very jumpy and easy to startle, but I'll just talk about my experience with bipolar. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. However, the use of supplements except in cases of deficiency may cause more harm than good. 8. Leafy vegetables, nuts, whole grains, and vegetable oils are rich in LA, while walnuts, flaxseeds, chia seeds, and soy nuts are rich in ALA. The Possible Culprit: An achy bod can indicate that you're low on the sunshine vitamin. Supplementing with iron generally helps decrease RLS symptoms, especially in people with a diagnosed iron deficiency. This article lists 20 foods that are high in vitamin A. Megaloblastic macrocytic anemias. Vitamin A deficiency is the world's leading cause of preventable blindness in children, and increases the risk of disease and death. Accessed Aug. 18, 2021. However, some health conditions and medical drugs can interfere with the synthesis and absorption of vitamin K. Vitamin K deficiency symptoms in adults include: mucus membrane bleeding (gums and nose) bone deformities. Vitamin K deficiency can also cause heavy bleeding. Approach to the anemias. These sensitive gums may be a sign of gingivitis or periodontitis, or it could be a vitamin deficiency that may cause bleeding gums. Rickets is a rare disease that causes the bones to become soft and bend. The specific symptoms of a vitamin deficiency will depend on which vitamin deficiency a person has. Using sunscreen can limit the amount of D you get, but it's worth it to prevent this deadly disease, according to Yale Medicine. Vitamin E deficiency Deficiency is rare but can happen in people with diseases that cause fat malabsorption (like cystic fibrosis ). Weight loss-surgeries. 18 January, 2019. It's been a lot in the newspaper with respect to our soldiers. It's exhausting to feel jumpy or overly sensitive to your surroundings all day, and it's hard to rest and restore yourself when you can't turn down the volume knob on your nervous system. They wake up with nightmares, loud noises make them duck and cover, and they're very irritable. Fortunately, vitamin A deficiency is rare in developed countries. Case report - Mme V., a 64-Year-old woman, was admitted to the hospital because of confusion. Extremely high iron levels can even be fatal in some cases, so its best to consult your healthcare provider before taking supplements (57). "If a vitamin deficiency is causing the issue, the sooner you address it, the more easily it can be remedied through changes to your diet or a dietary supplement," she said. The condition often appears in childhood and naturally disappears in adulthood. Biotin for Nails. "Sprinkle some on your oatmeal or salad, or mix half a cup into a smoothie.". This condition also occurs when a person's body fails to absorb these nutrients, or following certain gastrointestinal diseases or alcoholism. Tomatoes, bananas, potatoes, leafy greens and seafood are often rich in sodium, calcium, potassium and magnesium. Your rabbit may be blind or partially sighted if they regularly bump into things or if they're easily startled by sounds or approaching objects. The Fix: Incorporate plenty of high-iron foods into your meals. Deficiency diseases are diseases that are caused by the lack of certain essential nutrients, especially vitamins and minerals, in one's diet over a period of time. When the body repeatedly anticipates stressful events, it can seem like the faucet of arousal is always left open and running. A nutrient-poor diet can sometimes cause vision problems. Smile can vitamin deficiency cause erectile dysfunction and say, Well, work ethic. But sun exposure can also up your risk for skin cancer. While the link between a nutrient-poor diet and these skin conditions is not fully understood, people with dandruff or seborrheic dermatitis might want to consume more of these nutrients. information can be found Just as low levels of vitamin D can lead to lower back pain, being deficient in this important vitamin can impact the health of bones and joints throughout your body. Elsevier; 2021. https://www.clinicalkey.com. Vitamin deficiencies can cause easy bruising. Written by Erika Krull, MSEd, LMHP All clinical services and programs are part of University of Utah Health Hospitals and Clinics. Another tip: Cook with cast iron. In another small study, around 28% of patients with mouth ulcers had deficiencies in thiamine (vitamin B1), riboflavin (vitamin B2), and pyridoxine (vitamin B6) (11). "In cases of severe deficiency, your physician might give you an iron pill drink it with orange juice for optimal results," Jones says. Fatigue is usually the first sign of anemia. But we can fix that. Here, we look at eight signs that your system might be out of whack plus, easy diet tweaks and tips to get back on track. Robert M. Kliegman MD, in Nelson Textbook of Pediatrics, 2020 Clinical Manifestations of Vitamin A Deficiency. All rights reserved. Send us a message and well answer Brain fog. Nurture yourself with mental health advice thats rooted in medical Mayo Clinic is a not-for-profit organization. In: Williams Hematology. It's a serious problem in more than half of all countries, though it mainly affects poorer regions. o Option D: Bulimic clients should only be allowed to eat food provided by the dietary department. Thats because raw egg whites contain avidin, a protein that binds to biotin and can reduce its absorption (1, 3, 4). Folic Acid Deficiency. ">, DNV GL Public Information Policy Statement. Babies with severe vitamin D deficiency can get cramps (muscle spasms), fits (seizures) and breathing (respiratory) difficulties. The review mentioned above reports that it takes people with dark skin three to five times as long in the sun to make the equivalent amount of vitamin D as someone with light skin. A blood test to measure the number of red blood cells and amount of hemoglobin can tell if you have anemia. Women who've been sexually abused, women who've had a traumatic episode on the street, a near-death experience in a car accident. What gives? People who are hyperthyroid. Or maybe your periods have been heavier than usual or your gums have been bleeding when you floss. "Get your vitamin D status checked every four to six months," Jones says. So this is something where the baby is born with a trait of being arousable and being hyperalert based on the experience in-utero. Our website services, content, and products For example, a vitamin C deficiency can cause dental problems, bone fractures , dry eyes , and . So jumpiness? Foods rich in niacin, riboflavin, and pyridoxine include whole grains, poultry, meat, fish, eggs, dairy, organ meats, legumes, green vegetables, starchy vegetables, nuts, and seeds (15, 16, 17). Deficiencies of iron and copper reduce the rate of Hgb formation and produce typical nutritional anemia. https://www.dietaryguidelines.gov. Certain vitamin deficiencies are disease related. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. The Possible Culprit: Brittle tips are typically due to an external factor like picking at your polish, frequently using hand sanitizer or wearing acrylic nails. And when your heart is irregularly beating rapidly, it makes you startle easily. "Vitamin K is a coagulator that helps your blood clot properly," says Heidi Moretti, RD, a clinical dietitian and nutrition researcher. Reviewed by Jill Corleone, RDN, LD. Accessed Aug. 18, 2021. Many of them contain a combination of the nutrients above, in addition to several others. Keratomalacia. Alcoholics often eat poorly, limiting their supply of . Fact Checked by Wendy M Yoder, Ph.D. These little bumps may also be accompanied by corkscrew or ingrown hairs. Biotin, also known as vitamin B7, helps the body convert food into energy. After you reach middle age, you may need to take extra steps to get enough. Fact Checked by Victoria LeBlanc, MS, LCPC Foods rich in vitamin D include salmon, herring, sardines, canned tuna, oysters, shrimp and mushrooms. The Possible Culprit: A sudden loss of your sense of smell or taste can be a symptom of a few conditions and, especially nowadays, is often tied to the coronavirus. Here are 5 potential benefits of 5-HTP, Ritual is a subscription-based vitamin company that offers protein powders and multivitamins for people of all ages. Iron deficiency anemia signs and symptoms may include: Extreme fatigue Weakness Pale skin Chest pain, fast heartbeat or shortness of breath Adults are advised to consume required approximately 2.4 micrograms of vitamin B-12 daily, according to the Linus Pauling Institute at Oregon State University. Fatigue and Weakness This is a fat-soluble vitamin that plays an essential role in eye and immune health. Impairing nutrient absorption by damaging the cells lining the stomach and intestines. The average adult should get about 2.4 micrograms of B12 daily, according to the NIH. A research group has now developed a hypothesis whereby iron deposits in the brain -- resulting from alcohol-induced vitamin B1 deficiency -- can be regarded as key factors in cognitive. Since taste and smell are so closely linked, a reduced sense of taste is sometimes associated with a deficiency of B12 as well.